How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $42.66 | Professional | None | $28.84 | $42.66 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $114.82 Typical High $114.82 | Professional | None | $42.66 | $114.82 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | RR · Rental | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | UE · Used equipment | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Facility | None | $39.81 | $39.81 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
ConnectiCare Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
ConnectiCare Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $74.13 | Professional | None | $42.66 | $46.77 | $74.13 |
Health New England Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Health New England Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $57.54 | Professional | None | $23.99 | $33.11 | $57.54 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $6.46 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $4.90 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.24 | $4.27 | $4.27 |
Where Connecticut sits
The same service costs 2.3 times more in Kansas than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 35th of 51
$42.66
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.